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Generics Covered by Most Part D Plans

June 27, 2007

Due to the wide variety of Medicare Part D drug formularies, physicians often have difficulty ascertaining which prescription drugs are covered by which formulary — a problem that could be alleviated by prescribing generic drugs, according to a study published in The Journal of the American Medical Association (JAMA).

The study, featured in the June 20 issue of JAMA, examined Part D formularies in California and Hawaii, as well as nationwide plans, to determine whether there is at least one drug in several major treatment classes that is widely covered, which would help physicians in prescribing drugs within these classes.

The investigators found that 94 percent of widely covered drugs are generic, and 73 percent of all generic drugs are widely covered. In addition, only two out of 33 medications that are available only as brand drugs are widely covered, with most brand products being covered by roughly one-third of Part D formularies.

The study concluded that identifying which medications in these classes are widely covered would aid physicians in prescribing drugs within patients’ plans. But a good ‘shortcut’ would be to simply prescribe generics whenever possible, as they are widely covered in general and offer the additional benefit of low out-of-pocket costs.